title: Computational strategies unravel and trace how liver disease changes hepatic drug disposition.
abstract: Liver disease changes the disposition properties of drugs, complicating drug therapy management. We present normal and "diseased" versions of an abstract, agent-oriented In Silico Livers (ISLs), and validate their mechanisms against disposition data from perfused normal and diseased rat livers. Dynamic tracing features enabled spatiotemporal tracing of differences in dispositional events for diltiazem and sucrose across five levels, including interactions with representations of lobular microarchitectural features, cells, and intracellular factors that sequester and metabolize. Differences in attributes map to measures of histopathology. We measured disease-causing differences in local, intralobular ISL effects, obtaining until now unavailable views of how and where hepatic drug disposition may differ in normal and diseased rat livers from diltiazem's perspective. Exploration of disposition in less and more advanced stages of disease is feasible. The approach and technology represent an important step toward unraveling the complex changes from normal to disease states and their influences on drug disposition.
authors.affiliation: Department of Bioengineering and Therapeutic Sciences, University of California, 513 Parnassus Ave., S-926, San Francisco, CA 94143-0446, USA.
authors.forename: Sunwoo
authors.initials: S
authors.lastname: Park
authors.forename: Glen E P
authors.initials: GE
authors.lastname: Ropella
authors.forename: Sean H J
authors.initials: SH
authors.lastname: Kim
authors.forename: Michael S
authors.initials: MS
authors.lastname: Roberts
authors.forename: C Anthony
authors.initials: CA
authors.lastname: Hunt
mesh_terms: D000818:Animals; D001646:Bile / Q000378:metabolism; D003198:Computer Simulation; D018450:Disease Progression; D006801:Humans; D008099:Liver / Q000033:anatomy & histology / Q000378:metabolism* / Q000473:pathology; D008107:Liver Diseases / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D008954:Models, Biological; D010477:Perfusion; D004364:Pharmaceutical Preparations / Q000378:metabolism*; D051381:Rats; D012016:Reference Values
chemical_list: D004364:Pharmaceutical Preparations